Individual provider Active NPI

Michelle Lee Drake, LSCSW

  • Social Worker
  • Wichita, KS
National Provider Identifier
1174733232
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LMSW 6135 Issued in KS
Practice address
7926 W. 21St St. N.
Wichita, KS 67205
Phone
(316) 272-5502
Fax
(316) 453-6402
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW 6135 KS Primary

Addresses

Primary practice location

7926 W. 21St St. N.
Wichita, KS 67205

Mailing address

7926 W. 21St St. N.
Wichita, KS 67205
Phone (316) 272-5502

Other practice location 1

6700 W Central Ave Ste 106
Wichita, KS 67212
Phone (316) 945-5200

Other identifiers 1

IdentifierTypeStateIssuer
200442260BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMSW 6135KSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KJM Ventures Inc CurrentSince Dec 17, 2023 Accepting new patients
Restoration Counseling & Consultation, P.a. PastSince Sep 10, 2023 Accepting new patients

Locations

7926 W 21st St N
Wichita, KS 67205
Phone (316) 272-5502

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1174733232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7926 W. 21ST ST. N.",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-272-5502",
            "fax_number": "316-453-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 W. 21ST ST. N.",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-272-5502",
            "fax_number": "316-453-6402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6700 W Central Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "67212",
            "country_code": "US",
            "telephone_number": "316-945-5200",
            "fax_number": "316-945-5549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "LMSW 6135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200442260B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.